gastroesofagee

Gastroesofagee is a term used to describe the gastroesophageal region and the diseases that affect the gastroesophageal junction (GEJ). It encompasses the distal esophagus, the GEJ, and the proximal stomach, and is central to the process of coordinating swallowing and preventing reflux.

Anatomy and physiology: The GEJ is where the lower esophageal sphincter (LES) meets the stomach. The LES and the diaphragmatic crura together form a barrier to prevent gastric contents from entering the esophagus. The mucosa here is susceptible to acid and pepsin exposure when the barrier is compromised.

Common disorders and symptoms: Reflux disease (GERD) is the most frequent condition, with symptoms such as heartburn and regurgitation. Esophagitis, Barrett's esophagus, hiatal hernia, dysphagia, chest pain, and chronic cough can also involve the GEJ region. Esophageal cancer risk increases with chronic injury such as long-standing GERD, particularly in Barrett's esophagus.

Diagnostics and treatment: Diagnosis relies on patient history, endoscopy with biopsy, pH monitoring, impedance testing, and esophageal manometry. Management includes lifestyle changes (weight loss, meal timing, head-of-bed elevation), acid-suppressive therapy (proton pump inhibitors, H2 blockers), antacids, and, in selected cases, surgical fundoplication or endoscopic procedures. Surveillance is recommended for certain conditions like Barrett's esophagus.

Epidemiology and prognosis: GERD affects a significant portion of adults worldwide; prognosis depends on the specific condition and response to treatment. Early diagnosis and management reduce complications such as esophagitis and stricture.